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Sem 4: Nervous System > 12a.) Mood Disorders > Flashcards

12a.) Mood Disorders Flashcards

1
Q

What mood disorders do you need to be aware of at this stage?

A
  • Depression
  • Bipolar
    • Type 1
    • Type 2
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2
Q

State the 3 core symptoms of depression

A
  • Low mood
  • Lack of energy
  • Lack of enjoyment & interest
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3
Q

How long must patients have symptoms of depression for to be classed as clinically depressed?

A

Symptoms continually for 2 weeks

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4
Q

Alongside the core symptoms of depression, state some other symptoms

A

Core Symptoms

  • Low mood
  • Lack of energy
  • Lack of enjoyment & interest

Others

  • Depressive thoughts: burden, guilty, poor outlook
  • Somatic symptoms/biological symptoms: not eating, sleeping or drinking which can lead to weight loss and electrolyte distrubances
  • In severe cases psychotic symptoms
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5
Q

Explain the difference between an adjustment reaction (e.g. after death of a loved one) and depression

A
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6
Q

What is the typical sleep disturbance pattern in people who are depressed?

A

Early morning wakening

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7
Q

State some features of mania

A
  • Elated mood
  • Increased energy
  • Pressure of speech (talk very fast)
  • Decreased need for sleep
  • Flight of ideas
  • Normal social inhibitions are lost
  • Attention cannot be sustained
  • Self esteem is inflated, often grandoise
  • May have psychotic symptoms
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8
Q

Describe the difference between mania and hypomania

A

Hypomania is ‘milder’ form of mania

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9
Q

What is bipolar affective disorder?

A

Condition in which someone’s mood varies, GENERALLY, between two states: mania/hypomania and depression.

NOTE: diagnosis is made following 2 episodes of a mood disorder at least one of which is mania or hypomania hence you don’t ever have to have a diagnosis of depression to be given bipolar disorder diagnosis

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10
Q

Do you have to have a diagnosis of depression to be given diagnosis of bipolar disorder?

A

No. Diagnosis is made following 2 episodes of a mood disorder at least one of which is mania or hypomania. Hence, you don’t ever have to have a diagnosis of depression to be given diagnosis of bipolar disorder.

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11
Q

Describe the difference between bipolar type 1 and bipolar type 2

A
  • Bipolar type 1: discrete episodes of mania only or mania and depression (need at least 2 episodes)
  • Bipolar type 2: discrete episodes of hypomania only or hypomania and depression (need at least 2 episodes)
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12
Q

How long does bipolar episodes last?

A

Varies for individuals but generallyd depressive states last longer than manic states

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13
Q

If someone comes in with depressive symptoms, what physical health differentials might you make and want to rule out?

A
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14
Q

If someone comes in with mania symptoms what physical differentials might you make and want to rule out?

A
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15
Q

State 3 brain structures involved in mood disorders

A
  • Limbic system
  • Frontal lobe
  • Basal ganglia
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16
Q

Describe the main hypothesis for mood disorders

A
17
Q

State the 3 main functions of the limbic system

A
  • Emotion
  • Motivation
  • Memory (hippocampus & amygdala in particular)
18
Q

We have said that it is thought that the limbic system, frontal lobe & basal ganglia are involved in mood disorders. What possible changes do we think occur in the limbic system for:

  • Unipolar depression
  • Bipolar affective disorder
A
19
Q

Where is the pre-frontal area?

A
20
Q

State some functions of the frontal lobe

A
  • Motor function
  • Language (Broca’s)
  • Executive functions (purposeful goal directed behaviours e.g. when you go to shop to buy things for a meal, all the things you have to think about and do in the correct order)
  • Attention
  • Memory
  • Mood
  • Social & moral reasoning
21
Q

State at least 3 functions of the pre-frontal cortex

A

Responsible for the so called ‘executive functions’:

  • Emotional responses
  • Behaviour & judgement
  • Attention
  • Impulse control
  • Plan & organise
  • Problem solving
  • Decision making
22
Q

The ventromedial prefrontal cortex is thought to be involved in what?

A

Generation of emotions

23
Q

The orbital prefrontal cortex is thought to be involved in what?

A

Emotional responses possibly via connection with the amygdala

24
Q

We have said that it is thought that the limbic system, frontal lobe & basal ganglia are involved in mood disorders. What possible changes do we think occur in the frontal lobe in:

  • Unipolar depression
  • Bipolar affective disorder
A
25
Q

Basal ganglia have motor functions and psychologica functions; state 3 psychological functions of basal ganglia

A
  • Emotion
  • Cognition
  • Behaviour
26
Q

We have said that it is thought that the limbic system, frontal lobe & basal ganglia are involved in mood disorders. What possible changes do we think occur in the basal ganglia for:

  • Unipolar depression
  • Bipolar affective disorder
A
27
Q

For depression, state what symptoms/features abnormalities in each of the following structures leads to:

  • Prefrontal cortex
  • Amygdala
  • Basal ganglia
A
  • Prefrontal cortex: slowing of thought, altered executive function & altered emotional processing
  • Amygdala: abnormal emotional processing
  • Basal ganglia: impaired incentive behaviour, psychomtoor changes
28
Q

What are the two main neurotransmitters involved in depressive disorders?

A
  • Serotonin
  • Noradrenaline

(both are monamines)

29
Q

What is the monoamine hypothesis?

A

Suggests that depressive disorders are due to abnormality in the availability of monoamines (e.g. serotonin & NA)

**BOTH serotonin & NA are low in depression

30
Q

For serotonin, state:

  • Where it is produced
  • What it has roles in
A
  • Produced in brain stem (Raphe nuclei) and transported to cortical areas & limbic system
  • Role in:
    • Sleep
    • Impulse control (link with suicide)
    • Appetite
    • Mood
31
Q

Describe 3 pieces of evidence to support argument that serotonin is low in patients with depression

A
32
Q

For noradrenaline, state:

  • Where it is produced
  • Functions in brain
A
  • Produced in locus coeruleus (pons) and projects to limbic system & cortex
  • Functions: mood, role in behavioiur (arousal & attention), implicated in memory functions
33
Q

Describe 3 pieces of evidence to suggest that NA is decreasd in depression

A
34
Q

Describe the biopsychosocial treatment for depression

A
  • Biological
    • First liine: SSRIs
    • Others: SNRIs, TCAs
    • If life-threatening/resistant depression: ECT
  • Psychological
    • First line: CBT
  • Social
    • Help with e.g. isolation, social stressors etc..
35
Q

Describe the biopsychosocial treatment of mania

A
  • Biological
    • First line: antipsychotics
    • Alternatively: mood stabiliser
  • Psychological
    • Acutely will be unhelpful but longer term eduction regarding triggers and how to notice signs of relapse is beneficial
  • Social
    • Treat in place of safety, consider implications of mania e.g. excessive spending, STIs…
36
Q

Describe the biopsychosocial treatment for bipolar depression

*NOTE: we have to treat it different to unipolar depression as risk of sending them manic

A
  • Biological
    • Can use antidepressant BUT ONLY IF ALSO ON a mood stabiliser to prevent going hypomanic/manic
  • Psychological
    • CBT
  • Social
    • Same as for unipolar depression so help with e.g. isolation, social stressors
37
Q

Describe the biopsychosocial treatment for maintaining stability in bipolar disorder

A
  • Biological
    • Mood stabilisers
    • Some antipsychotics can be used as mood stabilisers
  • Psychological
    • Psychoeducation
    • CBT
  • Social
    • Consideration of lifestyle on bipolar e.g. shift work, stressful life…. involve family and educate family also

Sem 4: Nervous System (21 decks)

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